By Phyllis K. Kennemer
What is ADHD? A common definition states that Attention Deficit Hyperactivity Disorder is a mental disorder of the neuro-developmental type. It is characterized by problems with paying attention, excessive activity and difficulty controlling behavior.
Dr. Dale Archer, author of The ADHD Advantage: What You Thought Was a Diagnosis May Be Your Greatest Strength, disagrees. He has interviewed hundreds of people with ADHD and he discovered as an adult that he also fits into this classification. He has found that people with ADHD symptoms possess the ability to do multitasking, are risk-takers, have physical and mental energy and remain calm in the midst of chaos. They move quickly from task to task and have the ability to see the whole of an issue. In other words, they can see all the moving parts of a project and how these components relate to one another.
A growing number of children are being diagnosed with ADHD and are taking medications to deal with the perceived problems expressed in the traditional definition of the term. Estimates of these diagnoses vary from between 5 % to 10 % of young school age people. They have received this classification and many are taking prescribed drugs.
Dr. Richard Saul in his book, ADHD Does Not Exist, expresses concern that this “illness” is defined by its symptoms rather than its causes. There is no actual diagnosis. The symptoms of distractibility and impulsivity are real. But we are using an outdated, invalid definition of ADHD, one that has been kept in place for decades by physicians and other practitioners, along with pharmaceutical companies, the media, and even patients themselves.
Dr. Saul works with referred patients who have been diagnosed with ADHD. He has discovered that symptoms of ADHD are better explained by other conditions. It is his contention that ADHD, as we currently define it, does not exist. The majority of patients who came to his office with a primary diagnosis of ADHD qualified for other diagnoses which explained their symptoms more accurately. Many patients had no problem at all. He believes that the diagnosis and treatment of ADHD as we know it is wrong.
How did ADHD become such an integral part of our medical practices and school systems? The history of ADHD highlights the persistent ambiguity and controversy concerning both the symptoms and their sources.
A Retrospective Look at ADHD
Apparently, the symptoms of hyperactivity have been part of the human condition for many years. Sir Alexander Crichon mentioned “mental restlessness” in his writings in 1798 and George Still wrote a description of hyperactivity in 1902.
Since 1937 the core diagnosis of ADHD has remained essentially unchanged. The definition is based on symptoms related to inattention, such as failure to pay attention to details or instructions, difficulty with organization and distractibility. The “ailment” was treated with a stimulant called Benzedrine. Soon thereafter children with attention-deficit symptoms were diagnosed with “minimal brain dysfunction.” They were treated with the stimulants Ritalin and Cylert. In 1968, the symptom set was labeled as “hyperkinetic reaction of childhood.”
In the 1970s, it was commonly accepted that hyperactivity, distractibility and impulsivity tended to cluster together. The concept of attention deficit disorder with and without hyperactivity was introduced in 1980. In 1987, the label was changed to attention-deficit hyperactivity disorder, which remains the current name.
Recent studies and observations are revealing a genetic basis for ADHD. In 2013 Harvard University released a study linking genetic patterns to symptoms. Dr. Saul notes observations supporting this connection in his book. Shanna Pearson, an ADHD coach, believes that all ADHD is genetically based. Using information available through her intake data with thousands of clients, she has discovered that all of them can trace the trait to a blood relative – generally a parent, a grandparent, an uncle, or an aunt.
Research does not support popular beliefs that ADHD is caused by eating too much refined sugar, watching too much television, parenting techniques, or family chaos.
Most doctors’ diagnoses of ADHD are based on limited information. They often rely on antidotal information based on the observations of parents or teachers. Some doctors use check lists with nine traits related to inattention and nine traits common to hyperactivity. If patients are identified as exhibiting as few as five of the eighteen traits, they receive a diagnosis of ADHD and are given a prescription for a stimulant. Dr. Saul has stated that the “ease and carelessness with which ADHD is diagnosed is jarring.”
A major factor in the problem is that ADHD diagnoses are based totally on symptoms. Doctors seldom look for causes of the behaviors that are being identified. Dr. Saul has discovered a wide range of causes. Many of the young people referred to him are gifted and are, thus, displaying traits related to simple boredom – restlessness, tapping fingers on desks, daydreaming, etc. Other patients have specific learning disabilities, such as dyslexia, that have not been identified. Some have vision or hearing problems, sleep disorders, or identifiable mental illnesses.
The Truth Behind ADHD Stimulants
While stimulants may seem to help people at first, they often have undesirable side effects which develop the longer they are taken. Stimulants can cause problems, such as overstimulation, sleep disturbances, increased feelings of anxiety, irritability, and depression. Decreased appetite, unhealthy weight loss, poor concentration and memory loss are also common. The development of tolerance to the drug is a great concern. Doctors prescribe higher and higher doses of the stimulant to achieve the same effect which is a dangerous pattern. These large doses have contributed to an increase of self-destructive behaviors, including suicide.
Dr. Saul has also expressed concern that the over diagnosis and increased availability of stimulants has created a dangerous phenomenon on college campuses and even in some high schools, where young people take the pills at parties to lessen the drowsiness brought on by alcohol consumption. Sometimes the drugs are consumed to give them a perceived advantage in studying for tests and taking exams.
An Alternative to Medication
Shanna Pearson, one of the entrepreneurs featured in Archer’s book, is the founder and president of ADHD Coaching (www.expertadhadcoaching.com), a virtual enterprise that offers coaching services to adults throughout the world. Clients are provided with a set of tools to change and adapt behavior in appropriate ways while maintaining the creative traits that come with ADHD. She recommends treatment based totally on behavior modification and discourages clients from taking medication. Pearson says, “Pills don’t keep skills.”
Coaching time spent with individual clients varies from a few months to several years. Most clients can master the skills they need in about six months, but some people like to continue receiving the ongoing support for much longer.
Perhaps it is time for us to take a closer look at the definitions of ADHD and ascertain the actual causes of these supposedly negative behaviors. Recent research and professional observations reveal that the traits associated with ADHD may point to other health problems or no problem at all. More importantly, these symptoms appear in some of the most gifted and talented people on earth. The present reliance of stimulants as the preferred treatment could be concealing or obliterating the very traits that enable creative people to be successful beyond any expectations.